The change: Menopause no longer the secret it used to be

Monday

Apr 26, 2010 at 12:01 AMApr 26, 2010 at 12:37 PM

There was no “Menopause the Musical” when our mothers and grandmothers went through “the change.” There were no garish T-shirts with big letters proclaiming “When I am old I shall wear purple, with a red hat that doesn’t go …” There was not only no humor about this transition in a woman’s life, there was very little talk. Grandma only whispered about the symptoms to her very closest friend.

Geri Nikolai

There was no “Menopause the Musical” when our mothers and grandmothers went through “the change.”

There were no garish T-shirts with big letters proclaiming “When I am old I shall wear purple, with a red hat that doesn’t go …”

There was not only no humor about this transition in a woman’s life, there was very little talk. Grandma only whispered about the symptoms to her very closest friend.

But here we are in 2010, and women talk openly and even joke about menopause. They seek medical care from doctors who no longer push the issue aside as something only God can control. And, with longer and healthier lives, women are able to enjoy the good things that menopause brings.

Ask any woman who has found that life can get better after 50.

“Menopause is really quite a freeing experience,” says Janna Becherer, at 57 the owner of Brynwood (Ill.) Relationship Counseling, an activist in literacy, arts and other circles, a wife, mother and postmenopausal woman.

“It’s a relief not to have periods every month, and not go through the ups and downs of moods every month, plus all the physical symptoms that come with that,” says Becherer. “I really feel my emotions have evened out and this is a much nicer way to live.

“Plus, you don‘t have to worry about contraception anymore.”

Menopause, and other stages of a woman’s life, are open to discussion, even laughter. In Becherer’s office, which includes women from their 30s to their 60s, employees joke about how they can’t agree on where the thermostat should be set.

The menopausal symptoms that first got Becherer’s attention were hot flashes, especially the night sweats. Those were annoying, she says, although a king-size bed helped her and husband, Jack, weather the storm.

She tried some products from health food stores to alleviate hot flashes but didn’t have much luck. Finally, she went on a hormonal prescription with close medical supervision.

For a while, says Becherer, she felt “unfocused and flaky.” But that has passed. She leads a busy life, especially since her parents recently moved to town, but feels organized and in control.

Sex? Some minor changes come with menopause, but it doesn’t end a woman’s role as a sexual being, Becherer says.

“Sexual intimacy is important to me still,” she says. “It matters to me and is still a part of my life.”

No one can deny that menopause signifies a woman’s aging. Her time of being able to bear children is over. Does that mean she’s about to be old?

“I do look in the mirror and think, that’s not the face I used to see,” Becherer says. “Your metabolism changes and I can’t eat everything I want to, like I used to be able to.

“At the same time, there’s less pressure to look like the models in magazines. And I think maybe I’m on the verge of being a wise woman.”

This wise woman has plans. In 10 years, she says, she’d like to be semi-retired, still contributing to the community, traveling more and playing with grandchildren she hopes will arrive by then.

Here’s some menopausal advice from Becherer, whose expertise is marriage counseling, for both sexes.

To men who love women: “We’re just asking for patience and understanding. We’re not crazy. This is just a phase.”

And, to women: “If you do your best to gracefully accept moving into another of life’s chapters, you will find there are plenty of wonderful things you have yet to experience, and you can do so free of the constraints you may have felt as a younger woman.“

Your questions, answered

Jane Kiley, a nurse practitioner at SwedishAmerican Center for Women in Rockford, Ill., offers a primer on what women should know about menopause.

Question: What is perimenopause?

Answer: Literally, it means “around menopause.” The menopause transition can last several years, and the first stage is perimenopause. It is not uncommon for women in their mid-30s and early 40s to talk about menstrual changes, both in bleeding patterns and other early symptoms.

A: Hot flashes and night sweats that cause sleep disturbances, which cause fatigue, which causes crankiness. Two-thirds of North American women experience hot flashes. Some women tolerate symptoms easily, some find them embarrassing and annoying, and some find them debilitating. Most experience them three to five years before they taper off. Some women never experience them, and others will experience them into their 70s.

A: Everybody has them to some extent. Some people have just one or two symptoms; others have more.

Q: What are the treatments?

A: One is hormone therapy, which has been surrounded by controversy for a long time. The debate intensified after the Women’s Health Initiative in 2002 suggested an increased risk of heart disease and breast cancer in certain populations. The North American Menopause Society has published revisions since then, and we have learned that age is important. The risk/benefit ratio is highest in younger women who begin HT not long after menopause. They are the best candidates for this treatment. We learned that women older than 60 or women who have been in menopause for a number of years are not candidates to begin hormone therapy.

Q: How does HT help?

A: It is approved for relief of hot flashes and night sweats, prevention of osteoporosis and relief from atrophic genital tissues, which tend to dry out during menopause. Women with a uterus should use progesterone if taking estrogen hormone therapy. These medications can be administered orally, through the skin or through the vagina. Vaginal estrogen is by far the most prescribed in my practice.

Let me emphasize: The guideline on the use of hormone therapy is the lowest dose for the shortest period of time “to achieve the individual patient’s goals.”

Q: What about alternatives?

A: Some women find that low-dose antidepressants are beneficial in relieving hot flashes. Natural treatments include the use of vitamin regimes and products containing soy, red clover or black cohosh. Even though studies by NAMS have found alternative therapies to not be beneficial, many women find relief from these products.

Also, exercise, a nutritious diet and plenty of water go a long way in helping with a smooth transition.

Q: What does this mean to one's sex life?

A: The big question here is, what was your sex life like before menopause? If it was active and satisfying, you can expect it to remain so. But if you were not very interested in sex and received little pleasure from it, the future will probably be more of the same, especially with the addition of vaginal dryness.

It is helpful to women to make sure the vaginal tissues remain supple and moist so intercourse is not painful. There are ways to add estrogen to the vagina and external genitalia to treat tissues locally.

A woman not interested in using estrogen could use an over-the-counter product, such as Replens, for vaginal moisture, then add another product for lubrication for intercourse.

The crystal ball to female sexuality is so much more complex than for males that it would take volumes to address the issue.

Rockford Register Star

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